ITGCN of the Testis, Contralateral Testicular Biopsy and Bilateral Testicular Cancer

Over 30 years ago Skakkebæk was the first to characterize a noninvasive precursor lesion (intratubular germ cell neoplasia or carcinoma in situ) that would progress to invasive testicular tumors. In this article we discuss the molecular changes thought to cause this malignant transformation, various conditions that predispose to the development of testicular germ cell tumors, diagnostic strategies, and treatment options. Additionally we discuss the current patterns of contralateral testicular biopsy to identify intratubular germ cell neoplasia, as well as the incidence and management of bilateral testicular tumors.